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Angiotensin II acetate is in clinical development for the treatment of catecholamine and/or vasopressin resistant hypotension due to distributive shock. Shock is a critical condition in which blood pressure drops so low that the brain, kidneys and other vital organs cannot receive enough blood flow to function properly. Distributive shock is the most common type of shock that is most commonly caused by bacterial or fungal infection (septic shock) or allergic reaction (anaphylactic shock). Severe shock is usually treated with drugs called catecholamines or vasopressin. Shock that does not respond to treatment with these drugs is resistant shock.
This medicinal product is a formulation of synthetic angiotensin II administered by intravenous infusion. Angiotensin II is a naturally occurring hormone that regulates blood pressure by attaching to the angiotensin II type 1 receptor, causing the blood vessels to narrow, increasing sodium and water retention and increasing aldosterone and vasopressin release, all of which increase blood pressure. If licensed, angiotensin II acetate may provide a treatment option for people with refractory shock who do not have any other treatment options.

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Entresto (a tablet comprising a combination of the drugs sacubitril and valsartan), is in clinical development for people with chronic heart failure with preserved ejection fraction. Heart Failure (HF) is a complex clinical syndrome of symptoms and signs that suggest the efficiency of the heart as a pump is impaired. Symptoms include breathlessness and fatigue, and signs of the condition include swollen ankles and crackling sounds in the lungs. People with HF often have a poor quality of life, and about a third of people experience severe and prolonged depressive illness. About half of people with HF have a preserved ejection fraction (HF-PEF), meaning that over 50% of the blood in the left ventricle is pumped out with each contraction of the heart.

Udenafil works by blocking the enzyme phosphodiesterase type 5 which regulates the breakdown of ‘cyclic guanine monophosphate’ (cGMP) in the blood vessels of the lungs. Increased levels of cGMP leads to dilation (widening) of the vessels improving blood flow to the lungs, reducing the burden on the heart and improving oxygen supply to the blood. This is expected to improve the symptoms of the condition and may offer an additional treatment option for adolescents (12-18 years old) for the management of congenital heart disease after Fontan palliation who currently have few effective therapies available.

The current standard of care for patients with hypercholesterolaemia is primarily statins which are capable of reducing LDL-C. There is however a subset of patients who are unable to tolerate statins due to adverse effects. Bempedoic acid monotherapy or in combination with ezetimibe are once-daily tablets in development for patients unable to tolerate statins at all, or are not able to tolerate the necessary dose of statin required to reach their LDL-C goal, or are recommended not to use them due to various circumstances. Bempedoic acid and ezetimibe both act in complementary ways to lower LDL-C. These therapies may offer additional and effective treatment options to use in combination with dietary changes and other lipid-modifying therapies to treat primary hypercholesterolaemia or mixed dyslipidaemia.

Bempedoic acid lowers LDL-C via a different mechanism of action and offers the potential advantage of reduced muscular adverse effects when compared to statins which are the current standard of care. Bempedoic acid is being developed for patients at high cardiovascular risk who are unable to reach LDL-C goals with the maximum tolerated dose of statins. The effect of bempedoic acid is additive—not redundant—to that of statins, and if licensed, may offer additional and effective treatment option to use in combination with dietary changes and other lipid-modifying therapies to treat primary hypercholesterolaemia or mixed dyslipidaemia.